Kimberly J Prough, PAC
Physician Assistant in Indian Harbour Beach, FL. Individual provider (NPI-1).
NPI number1902811698
StatusActive
Last updated in NPPESOct 11, 2016
Details
- NPI
- 1902811698
- Entity type
- Individual (NPI-1)
- Name
- Kimberly J Prough
- Credential
- PAC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 30, 2006
- Last updated
- Oct 11, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9104973 | FL | Yes |
| 363A00000X | Physician Assistant | PA02977 | TX |
Practice location
2254 Highway A1aIndian Harbour Beach, FL 32937-4922
Phone 321-777-2273 · Fax 321-779-7425
Mailing address
2254 Highway A1aIndian Harbour Beach, FL 32937-4922
Phone 321-777-2273 · Fax 321-779-7425
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Other Physician Assistant providers in Indian Harbour Beach, FL
- Kristen Hoffower, PA-CNPI 1477325660
- Nicholle C Rothengass, PA-CNPI 1588138663
- Corey Smith, PA-CNPI 1619365095
- Nicole Kristine Trio, PA-CNPI 1245949650
All 5 Physician Assistant providers in Indian Harbour Beach · All 275 providers in Indian Harbour Beach
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